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Flashcards in Vascular Path Deck (35):
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Strawberry Hemangioma

Benign capillary, seen in infancy, appears early in life, grow rapid and spontaneously regress by 5-8y/o

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Cherry hemangioma

Benign capillary, geriatrics, don't regress, risk for them inc. with age

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Lymphangiosarcoma

Malignant, lymphatics, assoc with persistent lymphadenopathy

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Glomus tumor

Benign, painful, red blue tumor under fingernails, arises from modified smooth muscle cells of Glomus body

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Bacillary angiomatosis

Benign, capillary, skin papules, seen in AIDS, caused by bartonella henselae infection, mistaken for kaposi sarcoma

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Kaposi sarcoma

Endothelial malignancy, most commonly in skin but can be seen in mouth, GI, resp tract. Assoc with HHV8, and HIV. Can be mistaken for bacillary angiomatosis

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Angiosarcoma

Rare, occur in head, neck, breast, assoc with radiation therapy pt.

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Large vessel vasculaitis

temporal giant cell arteritis, takayasu arteritis

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temporal giant cell arteritis

granulomatous vasculitis; classically branches of carotid artery; most common form in older adults (>50); affects more females;

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tempoeral giant cell arteritis presentation

headache (temporal art. involved), visual distrubances (opthalmic artery), jaw claudication, flu like Sx with joint and muscle pain, elevated ESR

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temporal giant cell arteritis Bx

inflamed vessel wall with giant bodies and intimal fibrosis; segmental lesions so Bx needs to be big enough; negative Bx doesnt exclude disease

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temporal giant cell arteritis Tx

corticosteroids

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Takaysau arteritis

granulomatous vasculitis involves aortic branch; adults <50 classically young asian female;

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takaysau arteritis presentation

visual and neurologic Sx with weak or absent UE pulses; elevated ESR

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takaysau arteritis Tx

corticosteroids

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medium vessel vasculitis diseases

polyarteritis nodosa, kawasaki disease, buerger disease

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PAN

necrotizing vasculitis in multiple organs and the lungs are spared; lesions in varying stages fibrinoid necrosis; string of pearls seen

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PAN presentation

HTN, abdominal pain with melena, neurologic disturbances, skin lesions; assoc with HBsAg

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kawasaki disease

classically asian children; Coronary involvement is common

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kawasaki disease presentation

non specific signs of fever, conunctivitis, eryhematous rash of palms and soles, enlarged cervical nodes

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kawasaki disease Tx

ASA and IVIg; disease is self limited

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Buerger disease

necrotizing vasculitis involving digits; hioghly assoc. with heavy smoking

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Buerger disease presentation

ulceration, gangrene, autoamputation of fingers and toes; raynaud phenom present

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small vessel vasculitis

wegener granulomatosis, microscopic polyangiitis, churg-strauss syndrome, henoch-schonlein purpura

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wegener granulomatosis

necrotizing granulomatous vasculitis involving nasopharynx, kidneys, lungs

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wegener granulomatosis presentation

middle aged man, sinusitis, nasopharyngeal ulceration, hemoptysis with B/L nodular lung infiktrates, hematuria from RPGN; elevated c-ANCA

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wegener granulomatosis Bx

large necrotizing granulomas with adjacent necrotizing vasculitis

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wegener granulomatosis Tx

cyclophosphamide and steroids

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microscopic polyangiiitis

necrotizing vasculitis of multiple organs (lungs kidney); no granulomas; p-ANCA; Tx is steroids and cyclophosphgamide

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churg strauss syndrome

necrotizing granulomatous inflammation with eosinophils involing multiple organs especially heart and lungs; asthma and peri. eosinophilia is usually present; p-ANCA;

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Henoch-schonlein purpura

vasculitis due to IgA depostion; most common vasculitis in children;

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hecnoch-schonlein purpura presentation

palpable purpura on buttocks and legs; GI pain and bleeding; hematuria from IgA nephropathy; usually follows URI; self limited

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aortic dissection

major risks is HTN or connective tissue disorders

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thoracic aneurysm

tertiary syphillis, endarteritis; tree bark aorta;

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abdom aortic anyeursm

between renal and iliac arteries; due to athersclerosis; seen in male smokers >60 with HTN